Choosing Your Baby's Pediatrician
Tips for New Parents on Selecting Baby's Doctor
In
the early stages of my career as a Pediatrician, I spent considerable
time in the delivery room. After the baby was born and I pronounced the
infant healthy, the delivery room nurse would lean over to the joyful
parents and ask, "Who is the baby's Pediatrician?" The
father would look at the mother, the mother would look at the father,
and they would both exclaim, "We don't know!" At that
point, the obstetrician would state "Put the baby on Dr. Xs service"
and that Pediatrician would become the child's doctor. This really
struck me as odd—the parents had 9 months to choose a physician
for their infant, but somehow neglected to do this.
This is a decision that merits much more thoughtful consideration. The physician that you choose will be responsible for the health and well-being of the most important individual in your life. In addition, you will be amazed at the amount of contact you have with your Pediatrician, both in terms of office visits as well as phone consultations. Hence, it behooves you to find both a high quality physician as well as someone that you can easily interact with.
Where to start? Certainly the most common method is to ask a friend or neighbor whom they use. Although this is a reasonable first step, I encourage you to go further. After all, the worst physician in town has plenty of satisfied customers. Besides, your priorities and desired personality traits may differ from your friends'.
A better way to try to assess the quality of the physician is to talk to "people –in-the-know". By this I mean individuals who work with the physician and can more easily make a judgement regarding the physician's skill. Examples are your obstetrician, the nurses in Labor and Delivery and the Nursery in the hospital, the Emergency room doctors and nurses and the nurses on the Pediatrics floor of the hospital. You may not know any of these individuals (besides your obstetrician), but with a little "chutzpah" you can simply call these areas of the hospital and ask who they use for their Pediatrician. Likely, you will repetitively hear one name or just a few names.
Once you have a name or several names to choose from, I strongly encourage you to schedule a Pre-natal visit. This is simply a visit to the physician, at his or her office. Most physicians are happy to schedule these and most do not charge for them. This gives you the opportunity not only to ask some relevant questions, but even more importantly, to get a "feel" for the physician and the office. You will be able to assess the physician's personality style, as well as the friendliness of the office staff. Take note of the office itself—does it seem warm and friendly, is it child-centered? Are there plenty of free educational materials available? Does it appear to be well maintained and clean? Is hand-sanitizer readily available? Does the physician "practice what he preaches", i.e. is there a T.V. in the waiting room (most Pediatricians try to limit their patients T.V. time) or do they offer a sugary sweet as a patient treat?
What about the physician's style and manner? Is this a brusque, "old-style" physician who tells the parent what to do and does not invite discourse? Some parents prefer this style, finding it reassuring. Other parents prefer a physician who advises them on the current state of medical knowledge but allows the parent to participate in the decision-making process. Generally you can tell fairly quickly if the physician's personality meshes with your own, and if you feel comfortable with him/her.
What questions should you ask? Again, certain issues are more important to some individuals than others, so you need to think about what is important to you. Logistical issues may be important. The physical proximity of the office maybe significant, although to find a high quality M.D. that you are comfortable with may be worth a few extra miles to you. What are the office hours? What is the protocol after office hours? This varies widely. Some physicians simply refer all after-hours problems to the Emergency Room. Many Pediatricians have a surrogate advice-giver, usually a nurse. Would you rather speak to the physician? How promptly are after-hours calls returned? (This is a big issue—your infant may not know how to tell time for a while, and is just as likely to have a problem at 3am as 3pm).
What about during office hours? Can you talk to your physician at any time of the day, or only during a set phone hour? (or not at all—in many offices only the nurses give phone advice). How long does it take to schedule an appointment? Is there often a long wait in the waiting room? Is there a separate waiting area for sick children so that they don't infect those children who are only there for check-ups? How many patients are scheduled per hour? If this is a group practice, is an effort made to ensure continuity with one primary physician? Is this a traditional insurance-model type of practice or one of the newer "concierge-style" practices in which a membership fee is charged in return for a far greater level of service?
In addition to logistical issues, certain clinical questions may be relevant to you. Is the physician a strong breast-feeding proponent and does he/she have mechanisms in place to promote successful nursing? How does he/she deal with developmental/behavioral/emotional issues? Is there a major emphasis on wellness and disease prevention, including nutrition counseling? You may think of many other questions that you would like to discuss—now is the time to bring them up, so that there are no unpleasant surprises later.
Although the recommendations discussed here may appear laborious, I strongly believe they will ultimately prove to be very beneficial. Your Pediatrician's medical acumen, bedside manner and level of concern for your child's health and your peace of mind will have a major impact on your life. Thus, it is certainly worth putting forth a significant amount of effort to ensure that you make the best possible decision for you and your child.
